Cervical Cancer Screening CDS for OpenMRS
0.1.0 - ci-build
Cervical Cancer Screening CDS for OpenMRS
0.1.0 - ci-build
Cervical Cancer Screening CDS for OpenMRS, published by Hopena Health. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/dhes/cervical-cancer-cds/tree/main and changes regularly. See the Directory of published versions
| Draft as of 2026-03-08 |
<PlanDefinition xmlns="http://hl7.org/fhir">
<id value="CervicalCancerTreatment"/>
<text>
<status value="extensions"/>
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</text>
<url
value="https://hopenahealth.com/fhir/cervical-cancer-cds/PlanDefinition/CervicalCancerTreatment"/>
<version value="0.1.0"/>
<name value="CervicalCancerTreatment"/>
<title
value="Cervical Cancer Treatment — Ablation Eligibility and Modality Selection"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
<code value="eca-rule"/>
<display value="ECA Rule"/>
</coding>
</type>
<status value="draft"/>
<experimental value="true"/>
<date value="2026-03-08"/>
<publisher value="Hopena Health"/>
<contact>
<name value="Hopena Health"/>
<telecom>
<system value="url"/>
<value value="https://hopenahealth.com"/>
</telecom>
</contact>
<contact>
<name value="Dan Heslinga"/>
<telecom>
<system value="url"/>
<value value="https://hopenahealth.com"/>
</telecom>
</contact>
<description
value="Clinical decision support rule for treatment of cervical pre-cancer lesions. Implements WHO ablation eligibility criteria and treatment modality selection. Presents the clinician with a point-of-care ablation eligibility checklist (transformation zone type, lesion extent, suspicion of cancer) and recommends thermal ablation, cryotherapy, or excision (LEEP/LLETZ) based on eligibility and available data."/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="focus"/>
<display value="Clinical Focus"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="1287592000"/>
<display value="Thermocauterization of cervix"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<purpose
value="To guide treatment modality selection for women with HPV-positive, VIA-positive cervical pre-cancer, ensuring appropriate assessment of ablation eligibility and selection of the most suitable treatment method for the clinical setting."/>
<copyright value="Copyright 2026 Hopena Health. License: Apache 2.0"/>
<relatedArtifact>
<type value="derived-from"/>
<label value="WHO Guideline"/>
<display
value="WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, 2nd edition (2021)"/>
<url value="https://www.who.int/publications/i/item/9789240030824"/>
<document>
<url value="https://www.who.int/publications/i/item/9789240030824"/>
</document>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<label value="WHO Guidance"/>
<display
value="Ablation eligibility criteria: TZ type assessment, lesion extent, suspicion of cancer. Treatment preference: thermal ablation > cryotherapy > LEEP/LLETZ."/>
<url value="https://www.who.int/publications/i/item/9789240030824"/>
<document>
<url value="https://www.who.int/publications/i/item/9789240030824"/>
</document>
</relatedArtifact>
<relatedArtifact>
<type value="composed-of"/>
<display
value="Upstream: Triage routes VIA+ patients to treatment assessment"/>
<resource
value="https://hopenahealth.com/fhir/cervical-cancer-cds/PlanDefinition/CervicalCancerTriage|0.1.0"/>
</relatedArtifact>
<relatedArtifact>
<type value="composed-of"/>
<display
value="Downstream: Treated patients enter post-treatment follow-up"/>
<resource
value="https://hopenahealth.com/fhir/cervical-cancer-cds/PlanDefinition/CervicalCancerFollowUp|0.1.0"/>
</relatedArtifact>
<library
value="https://hopenahealth.com/fhir/cervical-cancer-cds/Library/CervicalCancerTreatmentDecision|0.1.0"/>
<action>
<title value="Treatment Assessment"/>
<description
value="Evaluate treatment indication and determine appropriate modality for cervical pre-cancer"/>
<trigger>
<type value="named-event"/>
<name value="patient-view"/>
</trigger>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Treatment Is Indicated"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</condition>
<action id="ablation-assessment">
<title value="Assess Ablation Eligibility"/>
<description
value="Present ablation eligibility checklist for point-of-care clinical assessment. Ablation eligibility requires: (1) no suspicion of invasive/glandular disease, (2) TZ fully visible (Type 1 or 2), (3) lesion within probe reach."/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Treatment Is Indicated"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</condition>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/action-type"/>
<code value="create"/>
</coding>
</type>
<dynamicValue>
<path value="payload[0].contentString"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Ablation Eligibility Checklist"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="payload[1].contentString"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Treatment Recommendation"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</dynamicValue>
</action>
<action id="contraindication-alert">
<title value="Ablation Contraindicated"/>
<description
value="Known contraindication to ablation — recommend excision (LEEP/LLETZ)"/>
<priority value="urgent"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Has Known Contraindication To Ablation"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</condition>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/action-type"/>
<code value="create"/>
</coding>
</type>
<dynamicValue>
<path value="payload[0].contentString"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Treatment Recommendation"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</dynamicValue>
</action>
<action id="cin2-consideration">
<title value="CIN2+ Diagnosed — Consider Excision"/>
<description
value="Patient has CIN2 or higher diagnosis — excision may be preferred even if TZ is ablation-eligible"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Has CIN2 Or Higher Diagnosis"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</condition>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/action-type"/>
<code value="create"/>
</coding>
</type>
<dynamicValue>
<path value="payload[0].contentString"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Treatment Recommendation"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</dynamicValue>
</action>
<action id="refer-oncology">
<title value="Cervical Cancer — Refer to Oncology"/>
<description
value="Patient has cervical cancer diagnosis — refer for oncology management, not screening pathway treatment"/>
<priority value="urgent"/>
<condition>
<kind value="applicability"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Has Known Contraindication To Ablation"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</condition>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/action-type"/>
<code value="create"/>
</coding>
</type>
<dynamicValue>
<path value="payload[0].contentString"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="Treatment Recommendation"/>
<reference value="Library/CervicalCancerTreatmentDecision"/>
</expression>
</dynamicValue>
</action>
</action>
</PlanDefinition>